The Musculoskeletal Specialist

Pearls of wisdom and experience from a soft tissue injury specialist. Commentary on the medical system, home cures, things you should and shouldn't do, and who you should see if you're looking for help.

Monday, April 16, 2007

I created this blog in order to give others a little bit of insight into what it's like being a physician treating musculoskeletal disorders. Along the way, I hope there'll be some discussion and dialogue between myself and others. I'm not really here to debate the effectiveness of X or Y but I'm sure opinions will be thrown into the mix, which I'll do my best to attempt to mark as such so any advice given here won't lead you, the reader, astray.

Anyway, let me tell you a bit of who I am and what I do. I'm a chiropractor by license, yes, which I'm sure immediately throws up the red flags of, "Fraud! Idiot! Fake Doctor!". And to be completely honest, I hardly harbor any ill-will towards that mode of thinking because, in all honesty, for 99% of the chiropractic profession out there, it's most likely true. My views on the chiropractic profession certainly aren't popular and will most likely gain me no favors from those in the higher-up positions, but I am firmly grounded in reality unlike most of my professional colleagues.

Visit any chiropractic website out there and you will be inundated with messages about "overall health", "subluxations", and "nerve interference." If any of you out there have been to a chiropractor who has "treated" these aspects, then you have been skillfully duped. Many chiropractors will say that medical doctors cannot perform the services they perform because "only chiropractors are trained properly to detect and correct subluxations." Oh, and if you don't know what a subluxation is, you're actually with me. "Subluxation" is the term that chiropractors throw around to define what it is they attempt to fix with their adjustments. The problem is that the profession does not have a set of criteria designed to say exactly what a subluxation is, what causes it, how to fix it, etc. This ambiguity allows doctors to have full freedom to basically make up correlations to symptoms and have the "magical correction" you need in order to feel better. In fact, there are only certain aspects to injuries that actually respond to manual manipulation of joints, and yet many chiropractors will adjust every single visit. Oh, and by the way, there's some evidence to suggest that repeated manipulation of areas causes cumulative microtraumas, reduction of lordosis curves of the spine (the curves of the cervical [neck] and lumbar [low back] regions), and an increased reliance on further manual manipulations to relieve the pain caused by the adjustments themselves.

There are some of us out there who are different. I myself am one of these physicians. I practice a very specialized osteopathic model called the "Fascial Distortion Model" that is, in my opinion, the best treatment option out there for almost every musculoskeletal injury (minus the surgical cases, of course). This model literally allows for things like ankle sprains on crutches to be healed in just single office visit. Frozen shoulders can be gone in anywhere from 2-5 visits. Any muscle strain or ligament sprain is usually fixed in a single visit. And it has nothing to do with my skills as a practitioner, but just that the model is really that good. And yet, differentiating myself from the scores of other chiropractors in the area who are running patient mills is difficult. Getting anyone to find out about the treatment, or give it a try, is difficult. It's a fault of the system and current environment. I'm the only person in the entire bay area who practices this technique (as it is not well known yet), and the next closest physician is an osteopath in San Diego.

I see a maximum of 15 patients a day, and that's a full schedule from 9 am to 6 pm. Often other chiropractors see up to 100 patients a day, with a patient being lucky to spend 5 minutes with a doctor. How is that providing good service? They will swear up and down that they are, in fact, providing good health care and improving health of their patients, but it is lip service and nothing more. Since moving back to the bay area in January, I have already seen about 5 patients who came from other chiropractors who complained about their lack of understanding, time invested, and that their treatments did nothing to help them. And I have to tell you, this is pretty common! In my very strong opinion, the only good DC's left are the ones that practice soft tissue techniques exclusively and only adjust when it is absolutely called for by patient presentation, mechanism of injury, and examination results.

My goal as a physician is to eventually bring patients over to the correct side of the fence and get some REAL therapy. Now that you know who I am and what I stand for, I hope you'll stick around in the future as I post further entries to this blog.

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Originally from a tiny town in Southeastern Indiana, Dr. Ratledge now finds himself residing in the bay area of California where he specializes in treating orthopedic and sports injuries with the Fascial Distortion Model. While he is a chiropractor by license, he does not believe in traditional chiropractic theory and makes it a point to practice only evidence-based methods that garner real results.